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HomeMy WebLinkAbout0175 SCUDDER AVENUE - Health H 175 SCUDDER AVENUE A HYANNIS I I 'N. N1 ........V_ .................. THE COMMONWEALTH OF MASSACHUSETTS BOARD .............. ------- 0 .......HEALTH ----------------OF..... .......... ....... . `\61 1 Appliration for Disimial Works Tonstrurtion Vrrmit A I* ereby made for a Permit to Construct or Repair an Individual Sewage Disposal System ................. .... .................................. ... ........... ....7........ Location-Address or Lot No. 7 Owner Address ..................... .................................................................................................. Installer Address Type of Building Size Lod� .-Sq. feet U Dwellinglf-No. of Bedrooms...............2.........................Expansion Attic Garbage Grinder aOther—Type of Building ............................ No. of persons....................._______ Showers Cafeteria Otherfixtures .................................................................................................................................................. Design Flow.......��........................gallons per person per day. Total daily flow___---:7— ...................gallons. 1:4 Septic Tank Liquid capacity.1(n'CX:gallons Length................ Width.___._........__ Diameter_-------------- Depth....._.......... Disposal Trench—No..................... Width.................... Total Length.._._..._._.____._._ Total leaching area....................sq. f t. Seepage Pit No I ................ 9 -------- ------------ Diameter..' D C)Cx: � Depth below inlet____________________ Total leaching area..................sq. ft. Z Other Distribution box ( i� Dosing tank di- loe 7- 7- 7-7 - 7- 77 , Percolation Test Results Performed by..... ................................... Date...7................................. Test Pit No. 1.....-L, minutes per inch Depth of Test Pit....I................ Depth to ground water.._.....___._.._..._._.. .0?1 rX4 Test Pit No. 2................minutes per inch Depth of Test Pit........_......_.... Depth to ground water.........__..._.....__.. 04 . .......A............r-7----- ....­.....Z/....................�Vz 0 Descrip Z�U.0 ..... ,,Vz_.X..... ................. 0, 1 1 �r................ ....... .... ......... .­2�. 1.212............... 1Z ............. ....................................................................................................................................................................................................... U Nature of Repairs or Alterations—Answer when applicable............................................ ----- ........................................ .................. .......................................................................................................................... .. .........I.,....... ........................... Agreement: The undersigned agrees to install the aforedescribed Individual Sewage Disposal Sy ttem in A�accordance with the provisions of TI ITI U 5 of the State Sanitary Code—The undersW* ned further agrees not to place the system in operation until a Certificate of Compliance has is by th ealth. Sign .Z 717 .- _?M... .............. ...... ........................ .... Application Approved By....'� ............. ...... ..... .............. ..... ............. . .. 7. .. .... ... Date Application Disapproved for the following reasons: p --------*------"----------------------------*------------------------------------------11-1--------- ......................................................................................................................................................................................................... Date PermitNo.......................................................... Issued....................................................... Date N ... .' Fss tt3?�..... . ...... �� .. . .TH-E,COMMOiVWEALTH OF MASSACHUSETTS BOARD O I-IEALTH Apphratiou for Uispossl ai Works Toustrnrtion ramit Application is hereby made for a Permit to Construct ( ) or Repair ( ' ) an Individual Sewage Disposal System at Location Address 4 or Lot No ' owner Address _...._.... �. _______________________________ _ ....�..,. 4_ .�............. ._ ..-....-..___ Installer �r Address Type of Building ", Size Lot._{1 _= .....Sq. feet Dwelling No. of Bedrooms._____ ________________Expansion Attic ( ) Garbage Grinder ( ) j,i°. ,Other—Type, of Building ............................ No. of persons _.__._______ showers ( ) — Cafeteria ( ) Otherfi res --------------------------•-•-•-•--••--••-•----•--•--.-•-------•-•-------•--------------_r------••. -...•--•---••-•--------- W Design Flow gallons per person per day. Total daily flow.......7, 5:=9...................gallons. 9 Septic Tank'.- Liquid capacity PC� _ llons Length................ Width................ Diameter_______________ Depth................ Disposal Trench—No ____________________ W�the ___._ Total Length..................... Total leaching area....................sq. ft. See a' e Prt IV�o.____.._ -__ Diameter.___._. ..-__ Depth below -nlet.................___ Total'14achin area____ ----- ----- z Other Distribution box ( Voyo Dosingnk '� Percolation Test Results Performed by....._. . .__. C__e_______ _____________ !____ Date___" ' ' 4 `., Test Pit No. 1______ _______minutes per inch Depth of Test Pit.................... Depth to ground•,water_____._..._.______._ (% Test Pit No. 2................minutes per inch Depth of Test Pit................_... Depth to ground'water........................ x ------------- O Descript of ..................... � .r G� T ., -: _ - x --------•-• ......... V Nature'of Repairs or Alterations—Answer when apphcble .___ ________ _________________________________ - ----- -.. Agreement `t The' undersigned agrees to install- the aforedescribed Individual Sewage Dispos 1 'System in`.accordance with the provisions of TIT iZ- 5 of the State Sanitary Code— The unders ned further agrees not to place the system in operation until a Certificate of Compliance h is t ealth V Sig . wow ••... ... ... ._.. Application Approved By------ ....... •--•- .............---• --- - - 2 .. Date Application Disapproved for the`following reasons-----------------:_________=______________-__________________________._________________._______.______.......__ ..............•--•-••--•-•-_..._...•---••-••-----•-•-•••-••••----•-•••••-•------••••-._........._..:__.....•-•--•-•-•---•=-••----•-••------•---•-----------•----•----.................................... ,r Date PermitNo.............................----•------------ ...... Issued -----------==------------------------ Date THE COMMONWEALTH OF MASSACHUSETTS BOARD CIF HEALTH .............. ...................OF..... �%y'':!j°' s.... "'..................................... THIS IS TO CERTIFY Thde:ihe Indiv>dual Sewage Disposal System constructed (' or Repaired ( ) by ,$$+ `--------------•-------•-----------•----•-•-----•--•--•-----.._. p't•i *s.r�+..2a��P i7 ��"f+� �Z Insta at !�'' �i' f1 lias been installed in accordance with the provisions of T 5 o The S a e.-Sanitary Code as described in the application for'] Construction Permit No..__ ______!,. '_-V/............_.. dated..... "` -_ *_ _ '_________________ THE ISSUANCE OF.THIS CERTIFICATE SHALL.N.OT BE CONSTRUED AS A GUARANTEE THAT THE SYSTEM. IALILL FUNC'ilON-,SATISFACTORY. DATE... ............. Inspector G •-•-_. ..-•-••--••-•...•--•• -•••_... •-• --••---•----• -••- THE COMMONWEALTH OF MASSACHUSETTS BOARD O HEALTH .l}' � OF..... 1 .... .�._._.... No.._._. FE ...... -, O Disposal nrk a T-Lonlikudion famit H" Permission is—hereby granted..__. to ConsstV, ) or Repair ( ) an Its vidual, Sewage/Dybrposal System atNo.. !!' ------ ..--- d" j `I --- .............................. Street r �� as shown on the application for Disposal Works Construction Pert No,�r'� Rated .•---__ ••--_----- Board of Health DATE............................................................................. ;.N FORM 1255 HOBBS & WA.RREN+,INC.+..PUBLISHE_RS - ra. i r Y w 1 r ry` . f 1 a r k � � �C , � •��ST ,c�/t3�G�S /��}' .. a• , .. .x r : ,,;`1J4`ti.l., • a t h 7, 3 b. ♦ r ' ., ••` :.�1`�7/��r .', � _ J. f(• '{ _ -r _• '.,.,i44i ras it.,.... t ,e,• ,+. d r ,* "` ,• ' l' «. ,t •,tZ^ '� n ,•.r `'~ .r dA �,, � ,`) e , '; • ! ` .. d - r . .++ �+ r �,. 97,E a ,. .• 3, .. . ,<< l�s� �.� r,ra>•� ;; , ,��,.d'.,,f" <, '` • - .• ' 77, � - `' `^! �• ,{••. ., "} •� r� �.:. a '�, * } ' .ti al f � •x. •f � /� , •• h Z d .,.+ x•' .J '.. ,d t•. J. 4. 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